NPIMap

Organization Active NPI

Main Street Counseling, LLC

  • Professional Counselor
  • Allentown, NJ
National Provider Identifier
1043610140
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC00415100 Issued in NJ
Legal business name
MAIN STREET COUNSELING, LLC
Practice address
16 Ichabod LN
Allentown, NJ 08501-1959
Phone
(609) 208-3053
NPI assigned
Aug 26, 2014
Last updated
Nov 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Justin Adam Kahn, LPCNPI 1245535251
Title
Licensed Professional Counselor
Phone
(609) 208-3053

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X 37PC00415100 NJ Primary

Addresses

Primary practice location

16 Ichabod LN
Allentown, NJ 08501-1959

Mailing address

16 Ichabod LN
Allentown, NJ 08501-1959
Phone (609) 208-3053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211124002278 NJ Part B Supplier - Clinic/Group Practice 7113317694 Receives reassigned benefits from 13 practitioners
Practice locations: Hamilton, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637020800000",
    "number": "1043610140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ICHABOD LN",
            "city": "ALLENTOWN",
            "state": "NJ",
            "postal_code": "085011959",
            "telephone_number": "609-208-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 ICHABOD LN",
            "city": "ALLENTOWN",
            "state": "NJ",
            "postal_code": "085011959",
            "telephone_number": "609-208-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-26",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-11",
        "status": "A",
        "authorized_official_last_name": "KAHN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "609-208-3053",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00415100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.